tracheobronchial disruption and diaphragmatic rupture. Most cardiac injury
due to blunt chest trauma involves compression of the vertebral column.
The right ventricle is the most frequently injured chamber due to its position.
Life-threatening emergencies following blunt
chest trauma require accurate assessments and rapid interventions to
prevent unnecessary complications and death. The major objective in the
initial management of these patients is to restore normal cardiopulmonary
function. This is accomplished by establishing an adequate airway and ventilation,
and correction of hypovolemia or low cardiac output.

Differential Lung Ventilation

Differential lung ventilation (DLV) requires a double-lumen endotracheal
tube and two ventilators set to cycle in sync. One ventilator acts as the
primary ventilator and the other as the secondary ventilator. DLV is usually
begun by applying equal tidal volumes to each lung while monitoring airway
pressures. If airway pressures are too high, the tidal volume in the less
compliant lung is adjusted downward while shifting volume to the other lung
in an attempt to avoid barotrauma. PEEP is then applied in inversely proportional
amounts to lung compliance to equalize the functional residual capacity
of each lung.